Your first antenatal (sometimes called prenatal) appointment with a doctor, obstetrician or midwife is usually when you are 6-8 weeks pregnant. It’s important to see a doctor in early pregnancy so that checks and tests can be arranged. Checks and tests are offered to you but you’ll be given time to think and research information, you don’t need to take any tests if you don’t want to.
Below is a list of the 10 checks and tests that are usually offered at the first antenatal visit. Most doctors refer patients to a local pathology company for urine and blood tests. It can take a few days for results to come back to the doctor.
Some of these checks and tests may be repeated in future antenatal visits to monitor for any health issues as your progress closer to childbirth.
1. Detailed health history
Your first appointment may take about 20-30 minutes so your doctor can get a clear picture of your health and anything that may affect your pregnancy. You will be asked about:
- Your past or current medical conditions and medications
- Your parent’s history of medical conditions, such as diabetes and high blood pressure
- Lifestyle habits, such as smoking and alcohol
- Previous pregnancies and birth
- Work setting, particularly if it’s a stressful environment.
Your partner may also be asked some questions about his health history and lifestyle habits.
This will help the doctor work out any health risks that may arise during your pregnancy or any health risks to your baby.
2. Weight
Your weight and height will be measured to calculate your body mass index (BMI). This will be used as a baseline for your pregnancy and your doctor will recommend a specific range of weight gain that is healthy for you and your baby. Most weight gain will happen in the second or third trimester.
Weight gain is something you can’t avoid during pregnancy. But the good news is that the extra weight usually drops off when you start breastfeeding.
3. Blood pressure
A blood pressure check will be done during your consultation. Blood pressure is usually low in the first and second trimesters. It then increases in the third trimester.
High blood pressure during pregnancy is a common health issue which can develop into a serious condition called pre-eclampsia. High blood pressure can cause health problems for you and your baby but can be safely controlled during pregnancy especially if it’s identified early.
Your blood pressure is considered high if it is higher than 140/90.
4. Full blood examination (FBE)
This blood test will check your general health and also screen for anaemia, infections and other diseases.
Anaemia occurs when there is a low amount of healthy red blood cells which reduces how much oxygen can be carried around the body and to your baby.
5. Ferritin
This blood test checks your iron levels. Ferritin levels show how much iron is stored in the body. Low ferritin levels in your blood confirms iron deficiency (low iron levels) which is common in pregnancy, especially in the third trimester.
6. Thyroid stimulating hormone (TSH)
This blood test will screen for thyroid diseases. The thyroid is an organ in the front of the neck that releases hormones that regulate many body processes such as metabolism and weight. Thyroid hormones are important for your baby’s brain and nervous system development in early pregnancy.
7. Urine MCS
This urine test will screen for a bacterial infection (e.g. urinary tract infection) or kidney disease. The urine test will look for protein, sugar or blood.
It is important to screen for urine infections even if you don’t have any symptoms because there is an increased risk of developing a kidney infection in later pregnancy.
If a bacterial infection is found, it can be safely treated with antibiotics.
8. Blood group and antibody screen
This blood test will find out your blood type (A, B, AB or O) and an Rh factor (positive or negative). If you already know your blood type then you may not need this test.
Incompatibility problems can develop between a pregnant woman who is Rh-negative who gives birth to a baby who is Rh-positive. If you have a negative Rh factor, you will be offered an antibody injection, called anti-D, during pregnancy and/or childbirth to prevent any complications if your baby is Rh-positive
9. Vitamin D
This blood test checks your vitamin D levels. Vitamin D is important for healthy bones. Vitamin D deficiency (low vitamin D levels) is common in Australia, especially in winter.
If your vitamin D levels are low, your doctor will recommend a daily vitamin D supplement which can be purchased from a pharmacy without a prescription.
10. Infections
Serology tests are blood tests that check whether or not you are infected with certain infections: hepatitis B, hepatitis C, HIV and syphilis. Sometimes someone living with these infections will not have any symptoms and the infections can go undetected. These infections can be transferred to a baby, known as mother-to-baby transmission.
Antibody tests are blood tests that check your immunity to certain vaccine-preventable infections: rubella and varicella zoster (chickenpox). Developing rubella or chickenpox during pregnancy can lead to pregnancy complications and birth defects.
References
- The Women’s. Weight and pregnancy [Webpage]. Accessed online at: https://www.thewomens.org.au/health-information/pregnancy-and-birth/a-healthy-pregnancy/weight-pregnancy
- Department of Health (2019). Clinical Practice Guidelines: Pregnancy Care. Canberra: Australian Government. Accessed online at: https://www.health.gov.au/resources/pregnancy-care-guidelines
- Lab Tests Online: https://www.labtestsonline.org.au/
- The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (2019). Antenatal Care during Pregnancy [Webpage]. Accessed online at: https://ranzcog.edu.au/womens-health/patient-information-resources/antenatal-care-during-pregnancy
